Second upper Manhattan outbreak claims first life; case count hits 16

NYC health officials said the second outbreak of Legionnaires' disease to hit upper Manhattan has resulted in the death of one victim. In addition, the case count has increased to 16. Pictured: Harlem's Sugar Hill Project, the source of the area's first outbreak, in which 27 people were sickened, and one of them died, over the summer.

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New York City health officials announced Wednesday that the second outbreak of Legionnaires’ disease to hit upper Manhattan has resulted in the death of one victim. In addition, the case count has increased to 16.

The victim has yet to be identified. Of the other 15 cases, seven victims remain hospitalized, seven have been discharged, and one was treated as an outpatient.

The NYC Department of Health and Mental Hygiene (DOHMH) announced last Friday that eight residents of the Washington Heights neighborhood had been infected during a five-day span. Those first eight victims ranged in age from younger than 40 to older than 80. The age breakdown has not been updated since that time.

While the DOHMH believes the risk of contracting the disease remains “very low,” officials said they expect more cases could be confirmed.

Acting DOHMH commissioner Dr. Oxiris Barbot released a statement last Friday that read: “The Health Department has identified a second cluster this season of Legionnaires’ disease in the lower Washington Heights area, and we are taking aggressive steps to ensure the safety of residents.”

The DOHMH said it had sampled 20 cooling towers – taking a closer look at 11 – in an attempt to pinpoint the source. WPIX-11 News was told that one cooling tower was not registered with the city, so it was not being inspected regularly.

Owners of the 11 towers that are being looked at more closely were ordered to remediate their cooling towers “based on preliminary results and out of an abundance of caution,” Barbot said.

First outbreak
The investigation into the area’s first outbreak pinpointed a cooling tower at the Sugar Hill Project as the cause for 27 illnesses – and one death – that affected residents of Washington Heights and Hamilton Heights. A strain of Legionella bacteria, which causes Legionnaires’ disease, was common between six patients and the Sugar Hill Project cooling tower.

Because of the proximity of Sugar Hill Project to the most recent outbreak, the DOHMH has ordered the building’s owners to re-clean and re-disinfect the building’s cooling system. That process was completed Oct. 5.

(Note: The DOHMH classifies the current collection of illnesses as a “cluster” because the cases are linked in time and space, but no common source for the illnesses has been located. If a common source is found, officials will recategorize this incident as an “outbreak.” This blog is classifying this as an outbreak.)

Warning issuedIn his Friday statement to the public, Barbot warned that “although the risk is very low, we urge residents and people who work in the area to take precautions.”

The statement went on to say: “Legionnaires’ disease is not contagious, and (it) can be treated with common antibiotics if caught early. Anyone with flu-like symptoms – such as cough, fever or difficulty breathing – should seek medical attention immediately.”

If you live, work or travel through the area, you need to be vigilant. An infected person might not have developed symptoms because the disease’s incubation period can be up to two weeks.

Watch for symptomsBecause symptoms of Legionnaires’ disease are so similar to those of other forms of pneumonia (lung infection) or influenza (flu), many cases go unreported. Centers for Disease Control and Prevention (CDC) statistics show that only about 20 percent (5,000) of the estimated 25,000 yearly cases in the United States are reported.

About 10 percent of people infected with Legionnaires’ disease will die from the infection.

Early symptoms of Legionnaires’ disease generally include:

severe headaches

fever (104 degrees or higher) and chills

muscle aches

suppressed appetite.

Symptoms, however, can worsen to include:

pleuritic chest pain (pain caused by inflamed lungs)

dyspnea (difficulty breathing)

cough, which can produce blood and mucus

gastrointestinal problems such as diarrhea, nausea, and vomiting (about one-third of Legionnaires cases produce these symptoms)

mental agitation and confusion.

More on Legionnaires

Legionnaires’ disease outbreaks and clusters have been linked to numerous sources of Legionella, including:

High-risk categoriesLegionella bacteria are contracted by inhaling microscopic water droplets in the form of mist or vapor. Legionella grow best in warm water and are found primarily in human-made environments.

Anyone can become ill from Legionella, although the majority of healthy people exposed to the bacteria do not. Those most susceptible to infection include:

people 50 years old or older

people with a chronic lung disease or COPD (bronchitis or emphysema)

smokers, either current or former

people with compromised immune systems

heavy drinkers of alcoholic beverages

recipients of organ transplants

people on specific drug protocols (for instance, corticosteroids).

Another record year?According to the CDC, 2017 was a record year for Legionnaires’ disease cases in the state of New York with 1,009 cases. With more than 128 cases reported across the state within the past three weeks, the Alliance to Prevent Legionnaires’ Disease is projecting the state record to be broken before the end of the year. As of the end of September, 875 cases have been reported, and 1,180 are projected by year’s end.

An average of 200 to 500 Legionnaires’ disease cases are reported in New York City every year. In 2017, the five boroughs reported 441 Legionnaires’ disease cases, a 64 percent increase from the 268 reported in 2016, according to the CDC.